Arousal: The Secret Logic of Sexual Fantasies by Bader Michael J

Author:Bader, Michael J. [Bader, Michael J.]
Language: eng
Format: epub
Publisher: St. Martin's Press
Published: 2003-01-18T00:00:00+00:00

6

The Role of Sexual Fantasies in Psychotherapy

The noblest pleasure is the joy of understanding.

—Leonardo da Vinci

Not everything that is faced can be changed; but nothing can be changed until it is faced.

—James Baldwin

In the course of investigating the twists and turns of a patient’s life, I inevitably encounter sex. In this chapter I want to describe how I work with sexual fantasies in psychotherapy. How does sex emerge as a topic? How do I approach its investigation? If the dynamics of sexual arousal involve someone’s most important psychological conflicts, how do I work with the many bridges between sexual and nonsexual issues? If, as I’ve argued, fantasies negate certain pathogenic beliefs that inhibit us, and if some of our basic problems in life stem from these same beliefs, then how do I use fantasies as a tool in understanding what really ails my patients? To answer these questions, it is important to describe in much more detail than I have so far exactly how I work as a psychotherapist.

The manner in which I practice psychotherapy is well suited to uncovering the hidden meanings of sexual fantasy because it is based on a theory of the mind that is especially sensitive to these meanings. When a patient and I discover the unconscious logic behind a particular sexual preference or daydream, we open a door to understanding the causes of the psychological problems that brought the patient into therapy to begin with. In my practice, these problems usually are not explicitly sexual in nature. In contrast to a sex therapist, who specializes in treating sexual dysfunction, I treat people seeking help with more general life problems, from marital strife, to work inhibitions, to severe states of depression and anxiety. As a result, my approach to sexual fantasies and sexual preferences, when they do emerge in therapy, is not to change or “fix” them unless this is something the patient explicitly wants. My clinical strategy involves making use of patients’ sexual fantasies and preferences to illuminate the innermost workings of their minds, which as a result helps us solve their other, nonsexual, problems.

Most of us are unaware of the deeper meanings of our sexual fantasies or preferences and lack the motivation to discover them. We go through our lives having sexual thoughts and daydreams every day, getting aroused now and then, and never feel the need to understand the exact chain of mental events that precede and cause our experience. Except if we’re in therapy. In therapy people not only have the opportunity, but often the motivation, to explore their sexual wishes and fears. The opportunity arises because the therapy relationship creates conditions that are safe enough for people to talk about private and embarrassing subjects like sex. The motivation comes from a number of sources, depending on the patient. Some people obviously want to talk about their sexual thoughts and feelings when sex is a problem of some kind. My patient Rob, for example, consulted me because of his inability to get, and stay, sexually excited with his wife, Nicole.

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